NIH, National Cancer Institute, Division of Cancer Treatment and Diagnosis (DCTD) NIH - National Institutes of Health National Cancer Institute DCTD - Division of Cancer Treatment and Diagnosis

Electrolytes assessed by point-of-care testing - Are the values comparable with results obtained from the central laboratory?

Author(s): Chacko B, Peter JV, Patole S, Fleming JJ, Selvakumar R

Publication: Indian J Crit Care Med, 2011, Vol. 15, Page 24-9

PubMed ID: 21633542 PubMed Review Paper? No

Purpose of Paper

The purpose of this paper was to determine the effects of analyzing whole blood at the bedside rather than serum after sending whole blood through a pneumatic transfer system (PTS) on sodium and potassium levels.

Conclusion of Paper

Clinically relevant decreases in sodium or potassium (when <3 mmol/L) were observed when whole blood was analyzed at the bedside rather than when serum was analyzed after PTS transport.

Studies

  1. Study Purpose

    The purpose of this study was to determine the effects of analyzing whole blood at the bedside rather than analyzing serum after sending whole blood through a PTS on sodium and potassium levels. Specimens for analysis at the bedside were collected into an ABG syringe coated with lithium heparin, while specimens for analysis in the central lab were collected in BD vacutainers for serum.

    Summary of Findings:

    After PTS transport, serum sodium levels, measured in the central lab using the AU2700, were an average of 4 mmol/L higher than whole blood levels measured using a GEM 3000 at the patient bedside (p<0.001). Generally, potassium levels in PTS transported serum and untransported whole blood showed good agreement (Lin concordance correlation, Pc0.96), but when potassium levels were below 3 mmol/L, the serum levels were, on average, 0.6 mmol/L higher in transported specimens, and the agreement between the two was low (Pc=0.53). The differences in levels of potassium (below 3 mmol/L only) or sodium between whole blood analyzed at the bedside and serum analyzed after PTS transport were clinically relevant.

    Biospecimens
    Preservative Types
    • None (Fresh)
    Diagnoses:
    • Not specified
    Platform:
    AnalyteTechnology Platform
    Electrolyte/Metal Clinical chemistry/auto analyzer
    Pre-analytical Factors:
    ClassificationPre-analytical FactorValue(s)
    Clinical chemistry/auto analyzer Specific Technology platform GEM 3000 (direct ion selective electrode)
    AU2700 (indirect ion selective electrode)
    Biospecimen Aliquots and Components Blood and blood products Serum
    Whole blood
    Storage Within hospital transportation method Not transported
    Pneumatic tube system

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